Independence is a double-edged sword

Sometimes, out of lonliness, keeping up appearances or a home are a waste of time

It is not unusual for a relative, or a home care worker, to come into the residence of a senior and find the housekeeping and personal hygiene completely ignored.

An individual who might have been a fastidiously neat and tidy person may suddenly seem to ignore many of the basic elements of self-care.

When it first starts, it can come as quite a shock.

It’s important to understand that there is no single reason for self-neglect, nor does the elderly person necessarily view the situation as a problem.

In fact, most might simply shrug their shoulders and concede that this is their “lot in life.”

The conditions that surround them are, to them, normal and despite the fact that self-neglect is the greatest reason elders are reported to social assistance agencies, most are adamant about maintaining their independence.

There are some people whose self-neglect is an indication of depression or deteriorating mental health.  It can be particularly devastating, after the loss of a spouse, to maintain the routines that were once part of a long-term agreement for “division of duties” in the house.

It’s not uncommon, in the wake of new-found loneliness, to conclude that all of the efforts to keep up a house, or keep up appearances, are a waste of time.

Sometimes counseling, or more frequent visits from friends and relatives, can relieve the symptoms of this loss and restore some routine in life.

Alternatively, completely ignoring one’s personal hygiene, pet hygiene and home cleanliness can be an indication that the mind is not processing information clearly.  The person may not recognize or understand that his/her actions, or inactions, are leading to a potentially dangerous health risk.

A continuous deterioration of living conditions may necessitate an intervention to ensure a minimum level of hygienic safety is maintained, either through support agencies that come into the home, or perhaps placing the elderly person in a better personal care situation outside their own home.

The challenge for a family, of course, almost always centers around who has the right to make a decision about what is in the best interests of an elderly person.

While we might all agree that maintaining independence is the most important objective we should have for our aging family members, the reality is that independence is a double-edged sword when someone is not capable of making reasonable independent decisions.

As painful and difficult as it might be to do so, sometimes a family intervention to return some level of dignity and safety is necessary when self-neglect becomes obvious and persistent.

As it “took a village” to raise our children, so too does it take a village to keep an eye out for our aging relatives.

Every visit someone makes should include observations of general living conditions and personal hygiene to determine if the level of interest in maintaining the usual standards is dropping.  If so, then a little rallying of resources and options might be needed to avoid a continued deterioration and personal safety crisis.


Graham Hookey writes about education, parenting and eldercare (

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